NCT05256875

Brief Summary

Non-adherence is defined as: "the extent to which a person's behaviour - taking medication, following a diet, and/or executing lifestyle changes, corresponds with agreed recommendations from a health care provider". Non-adherence in chronic cardiometabolic diseases including diabetes is very common and is often the primary reason for treatment failure. This leads to significant excess costs to the health economy through avoidable investigations, treatment escalations, hospital admissions, and disease complications. Methods to diagnose non-adherence have until recently been poor. We have recently developed an objective and robust chemical adherence test to detect the presence of 160 cardiovascular medications in urine using high performance liquid chromatography-tandem mass spectrometry (LC-MS/MS). Chemical adherence testing has not been utilised in people with diabetes, further its relationship with other measures of adherence is unknown. The main aim of this observational study is to compare chemical non-adherence with other commonly used measures of non-adherence in people with diabetes. Chemical testing for non-adherence will be performed using urine provided by 600 patients with poorly controlled diabetes attending primary care recruited over a 15-month period. Participants will also be required to complete a self- reported questionnaire and pharmacy records will be reviewed to ascertain prescription refill rates. The prevalence and metabolic control of non-adherence as diagnosed chemically will be compared with those obtained by pharmacy refill rates and patient self-reported questionnaires. Further, the determinants of non-adherence as ascertained by urine LC-MS/MS analysis will be studied. It is hoped that this innovative study will lead to further larger intervention studies that will change the management of non-adherence in diabetes.

Trial Health

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Monitor

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
90

participants targeted

Target at P50-P75 for all trials

Timeline
Completed

Started Aug 2022

Typical duration for all trials

Geographic Reach
1 country

2 active sites

Status
terminated

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

February 16, 2022

Completed
9 days until next milestone

First Posted

Study publicly available on registry

February 25, 2022

Completed
6 months until next milestone

Study Start

First participant enrolled

August 30, 2022

Completed
2.8 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 17, 2025

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

June 17, 2025

Completed
Last Updated

December 16, 2025

Status Verified

December 1, 2024

Enrollment Period

2.8 years

First QC Date

February 16, 2022

Last Update Submit

December 8, 2025

Conditions

Outcome Measures

Primary Outcomes (1)

  • Measurement of the agreement between the prevalence rates of non-adherence obtained by LC-MS/MS and the prevalence as diagnosed by (Medication Possession Ratio) MPR ≤0.80

    One clinic visit

Secondary Outcomes (3)

  • Measurement of the agreement between the prevalence rates of non-adherence diagnosed by LC-MS/MS and that diagnosed by Hill-Bone Medication Adherence Scale (HB-MAS) <36

    One clinic visit

  • Measurement of the difference between metabolic control as assessed by HbA1c, LDL-cholesterol and clinic BP and the three methods to diagnose non-adherence

    One clinic visit

  • Determination of significant predictors of non-adherence as diagnosed by urine LC-MS/MS

    One clinic visit

Interventions

Urine/blood samples will be collected from participants, also they will be asked to complete a medication adherence questionnaire, medication records will also be examined to determine the pharmacy refill rate.

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)
Sampling MethodNon-Probability Sample
Study Population

Male and female (non-pregnant nor breast feeding) subjects with uncontrolled diabetes attending their routine Diabetes review that are capable of giving informed consent, who are above 18 years of age, and have been prescribed at least one oral hypoglycaemic agent and one other medication for cardiovascular disease.

You may qualify if:

  • Aged 18 years and over
  • Confirmed diagnosis of type 2 diabetes
  • People with at least one HbA1c ≥ 7.5% (59mmol/mol) measured in the last 6 months
  • Patients on at least one OHA and one other oral cardiovascular medication for blood pressure, diabetes or lipid lowering therapy
  • Patients able to understand written and verbal English

You may not qualify if:

  • Type 1 diabetes
  • Age less than 18 years
  • Patients unable to give informed consent
  • Pregnant or planning pregnancy
  • Terminally ill
  • Patients on simvastatin and or aspirin if they are the only other medication for cardiovascular disease besides the OHAs that the patient is prescribed.
  • Patients on insulin or GLP-1 analogues if they are the only other medication for cardiovascular disease that the patient is prescribed.
  • Major medical or psychiatric illness
  • Patients unable to understand written and verbal English

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

The Banks Surgery

Loughborough, LE12 7RD, United Kingdom

Location

The Cottage Surgery

Loughborough, LE12 8RY, United Kingdom

Location

Biospecimen

Retention: SAMPLES WITH DNA

Urine \& blood samples

MeSH Terms

Conditions

Diabetes Mellitus, Type 2HypertensionMedication Adherence

Condition Hierarchy (Ancestors)

Diabetes MellitusGlucose Metabolism DisordersMetabolic DiseasesNutritional and Metabolic DiseasesEndocrine System DiseasesVascular DiseasesCardiovascular DiseasesPatient CompliancePatient Acceptance of Health CareTreatment Adherence and ComplianceHealth BehaviorBehavior

Study Design

Study Type
observational
Observational Model
COHORT
Time Perspective
PROSPECTIVE
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

February 16, 2022

First Posted

February 25, 2022

Study Start

August 30, 2022

Primary Completion

June 17, 2025

Study Completion

June 17, 2025

Last Updated

December 16, 2025

Record last verified: 2024-12

Locations